HomeMy WebLinkAbout23-6524 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED69867 170
27
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-6524 2 0 5
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
cowsloN 06 - 08 - 2023 0827 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 3RD ST BLOCK e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 480 00 FMILES EET e S ❑ E e RAINIER AVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2068503325 0 11
30
6� LAST NAME PHOMPANYA FIRSTNAME NYENG MIDDLE 1 2 31
INITIAL
STREET ❑, 4616 MARTIN LUTHER KING JR WA APT 400 CITY SEATTLE ST WA ZIP' 981082163 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO YES R No�/
8❑ LRIIVERS STATE WA SEX'M MM DAY' 03 1— 07 — 1943 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E ICNLJAUSSY 1 NATURE OF INJURIES 2❑
3
10 9❑ Pi aT�S� AJU2308 sTArr WAurN# 1HGCM56835A187331
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM ro
TRLR. TRLR 7 1 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE I MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 2005 HOND ACCOR 4D DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO NYENG PHOMPANYA 4616 MARTIN LUTHER KING JR WA SEATTLE WA 98108 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI V INSURANCE INSURANCE CO ALLSTATE 964 085 975 3 4
IN EFFECT &POLICY# 9TOP
VE—L' CHARGE 1 5 36
LEGALLY
Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062000112
16 a
LAST NAME PRASEUTH FIRST NAME KEOOUDONG MIDDLE
INITIAL
17❑ STREET ❑', 4913 S PILGRIM ST CITY' SEATTLE ST WA ZIP 981185649 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES
t l NO
�
19 LICENSE#DRIVER'S STATE WA SEX MMDC7YY
M D.O.B. 05 _ 15 _ 1978 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CBG6923 TArE WA VIN# 1GBSHDC41E1125960
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2014 MAKE CHEV MODEL EXPRESS STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO CARGO COMPONENTS INC 827 W MAIN ST SUMNER WA 98390 VEHICLE NO.2
SHADE IN DAGED AREA
2 4
LIABILITY INSURANCE INSU&PORGY#E CO OHIO SECURITY INSURANCE CO BAS 60307275 IGQ
5
IN EFFECT
VEHICLE ❑ ,.I—I CITATION# CHARGE
LEGALLY YES N`LJ
25 s � e
7.111CjEo-S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
HNSON 0505 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED69867
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6524
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PHOMPANYA VANH
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
9740 10TH PL SW UNIT 104 SEATTLE WA 98106 2065736408 SEXi F MMDDvyry 08 - 07 - 1951
PASSENGER WITNESS❑ UNIT# 1 PEA 3 AIRBAG 2 RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES
USE CLASS '1
NAME
(LAST,FIRST,MIDDLE INITIAL) PRASEUTH LOUIE
ADDRESS&PHONE# DOB
4913 SPILGRIM ST SEATTLE WA 981185649 2062000112 SEX' M MMDDvvvv -
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 2 POS 6 AIRBAG 1 RESTR. 4 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) PRASEUTH MAKAI
ADDREss PHONE# 4913 S PILGRIM ST SEATTLE WA 981185649 2062000112 SEX M D.o.E. _ _
MMDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT q AIRBAG 1 RESTR. 4 EJECT 1 HELMET NJURY 1 NATURE OF INJURIES
❑ SEATPOS. USE CLASS �F----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
CO.JOHNSON 06-08-23 09:39 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 6/13/2023 2:19:54 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 8:29 AM TIME POLICE ARRIVED]8:33 AM
PART I PAGE IT]OF
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED69867
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6524
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PRASEUTH KEO
(LAST FIRST,
ADDRESS&PHONE#
4913 S PILGRIM ST SEATTlE WA 981185649 2062000112 SEX M MMDDYyry -
PASSENGER I�I WITNESS[]'UNIT# 2 P� 9 AIRBAG 1 RESTR. q EJECT ? 1 HELMET INJURY NAruRE of INJURIEs
L`!1 USE CLASS 1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
CO.JOHNSON 06-08-23 09:39 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 6/13/2023 2:19:54 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 8:29 AM TIME POLICE ARRIVED]8:33 AM
PART I PAGE IT]OF
REPORT NO. ED69867 CASE# 23-6524 OF COLLISION
06/08/23 08:27
OF CbLLI510N
NARRATIVE
U2 EB 200 S 3rd St In #2, U1 EB In #1; U1 left turn into parking lot (Safeway) and collided with U2;
U1 Improper Turn/FTYROW
On 06-08-2023 at about 0833 hours, I responded to a two vehicle collision in the 200 block of S 3rd St
in the City of Renton, County of King. I observed Unit 01 pulled to the north side of the roadway and
partially blocking the entrance to a commercial parking lot. Unit 02 was further to the east and
blocking lane #2 (of 2). 1 contacted both drivers at their vehicles and confirmed there were no injuries
from the collision that needed immediate medical attention. I instructed the drivers to move their
vehicles into the Safeway parking lot to the north and wait for additional contact.
The driver of Unit 01 was identified by WA DL and was seated in the driver seat of the vehicle. The
driver indicated that he was east bound in lane #1 (of 2) of the 200 block of S 3rd St. The driver
wanted to turn into the parking lot of Safeway and initiated a left turn from lane #1. The driver said he
did not see Unit 02 prior to the collision.
The driver of Unit 02 was identified by WA DL and admitted to driving the listed vehicle. The driver
indicated that he was east bound in lane #2 (of 2) of the 200 block of S 3rd St. Unit 02 was driving
straight ahead when Unit 01 side swiped his vehicle. The driver said the occupants of his vehicle
were his children and they verbally provided their names.
The 200 block of S 3rd St is a one-way street for east bound traffic only. There are two lanes for east
bound vehicular traffic and marked vehicle parking stalls on the north and south sides of the roadway.
The Safeway parking lot is to the north of the roadway.
The proximate cause of the collision was Unit 01 making an improper left turn. A vehicle intending to
turn left shall approach the turn in the extreme left-hand lane available to traffic moving in the
direction of travel of the vehicle. Unit 01 should have approached the left turn in lane #2, which was
occupied by Unit 01. Were it not for the actions of the driver of Unit 01, the collision would not have
occurred.
No citations or infractions issued. Report for information and insurance purposes.
PAGE 4 OF 5
REPORT NO. ED69867 CASE# 23-6524 DATE AND TIME 06/08/23 08:27
OF COLLISION
s
"Not to Scale"
S 3rd St
Rainier Ave S
PAGE 5 OF 5